Home Industries Health Services R.I. health insurance commissioner approves double-digit 2026 rate hikes

R.I. health insurance commissioner approves double-digit 2026 rate hikes

Updated at 2:08 p.m.

By

Katie Castellani

-

09/15/2025

Screenshot 2025-09-15 at 1.16.09 PM — RHODE ISLAND’S Office of the Health Insurance Commissioner has approved commercial health insurance premiums for 2026. While the rate changes aren’t as high as what insurers originally proposed, they are greater than last year’s as costs of health care services and drugs continue to rise./COURTESY OF THE R.I. OFFICE OF THE HEALTH INSURANCE COMMISSIONER.

CRANSTON – The R.I. Office of the Health Insurance Commissioner on Monday approved the commercial health insurance premiums for 2026. While the rate changes aren’t as high as what insurers originally proposed, they are greater than last year’s as costs of health care services and drugs continue to rise. Overall, OHIC’s approved weighted average rate

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CRANSTON – The R.I. Office of the Health Insurance Commissioner on Monday approved the commercial health insurance premiums for 2026. While the rate changes aren’t as high as what insurers originally proposed, they are greater than last year’s as costs of health care services and drugs continue to rise. Overall, OHIC’s approved weighted average rate changes are 21% for the individual market, 17.6% for the small group market and 19.3% of the large group market. Participants will save $59.3 million in 2026 compared to what the commercial health insurers requested, according to OHIC. “Premiums in Rhode Island and in many states across the country will rise more significantly next year than they have in recent memory,” said R.I. Health Insurance Commissioner Cory King. “To guard against double-digit rate increases becoming the new normal, large health care provider organizations and health insurers need to bear more accountability for managing costs and providing access to affordable health care.” Minutes after OHIC announced the approved 2026 premiums Monday, Gov. Daniel J. McKee’s office issued a statement directing the office to take an “aggressive” review of the drivers of health insurance premiums and identify ways to control costs. “Rising health insurance premiums are creating real strain for families across Rhode Island. They simply cannot continue to absorb these costs,” McKee said. “In discussions with the Office of the Health Insurance Commissioner, we have agreed that it’s crucial to create additional tools to strengthen the office's regulatory authority to better control costs for Rhode Islanders. And that’s exactly what we plan to do.” McKee highlighted several priorities to be addressed in a legislative proposal including: capping drivers of premium costs like administrative charges; strengthening OHIC’s authority to contain overall premium costs beyond what the law already allows; and implementing a temporary moratorium on new unfunded health insurance mandates to allow time to assess the costs of existing requirements and make sure future mandates don’t “unintentionally” raise premiums. OHIC rejected all insurer-proposed increases in administrative costs, per member per month, as a way to reduce the financial burden on Rhode Islanders. Over the last two years, OHIC says it has limited administrative cost increases to the rate of inflation. Along with higher usage and pricing factors, individual market premiums are rising partly because of the federal Enhanced Premium Tax Credits expiring. These tax credits lower qualifying Rhode Islanders’ premiums when they purchase coverage through HealthSource RI. They were authorized through the American Rescue Plan Act of 2021 and extended by the Inflation Reduction Act of 2022. Under current law, the tax credits are set to sunset after 2025, unless they are extended by Congress. Those currently using premium tax credits to enroll in coverage through HealthSource RI are expected to see an 85% rise – or almost $1,250 per household each year – in the average monthly cost of their plan, according to OHIC. If the tax credits were not expected to retire, the approved rate increases for individual markets would have been 16.4% for Blue Cross & Blue Shield of Rhode Island, instead of the requested 22%, and 17.2% for Neighborhood Health Plan of Rhode Island, instead of the 20.5% requested. Insurers are expecting fewer individuals to purchase insurance after the Enhanced Premium Tax Credits expire. This means healthier people will be leaving the insurance risk pool, leading to higher premiums for those who stay as fewer members will be there to subsidize their costs. Also, the R.I. General Assembly added a $50 health insurance fee, per member per person, as part of the Fiscal Year 2026 budget to fund recently enacted Medicaid rate increases. Because the fee, which raises premiums by 0.5% to 0.6%, was set after rate filings were submitted in May, OHIC says it had to add the fee to the requested rates. Since the rate filings were submitted, OHIC says it reviewed medical and pharmacy expense trend assumptions, administrative charges and margin requests from each insurer. Along with rejecting proposed premium increases in administrative costs, OHIC also rejected proposed tariff charges. Some insurers requested higher rates to reflect tariff’s potential effect on pharmaceutical costs, but OHIC didn’t find enough concrete evidence that pharmaceutical tariffs would be implemented. Some insurers’ contributions to reserve requests were reduced to help lower rates. Also, OHIC found changes to insurers’ utilization and pharmacy trend assumptions and adopted them to lower rates. In the past several years, R.I. Attorney General Peter F. Neronha hired actuaries to review all the rate filings and submitted public comment on the proposed premium increases. But this year, Neronha did not review the filings or submit public comment and instead hired a health economist to provide testimony during public hearings on individual market rate filings. Dr. Christopher Whaley, Neronha’s health economist, said the rate increases have harmful effects on consumers and households. The approved rates don’t apply to self-funded employer groups, which account for about 65% of Rhode Islanders’ with employer-sponsored coverage. Self-funded employers pay health care expenses of their employees and dependents directly, usually relying on health insurance companies for administrative services, according to OHIC. Rate increases that OHIC approved: Small-group rates:

Blue Cross & Blue Shield of Rhode Island: 17.7% increase approved after requesting a rate 22.2% hike.

Neighborhood Health Plan of Rhode Island: 17.0% increase approved after requesting a rate 20.3% hike.

UnitedHealthcare of New England: 15.9% increase approved after requesting an 21.2% rate hike.

UnitedHealthcare Insurance Co.: 15.1% increase approved after requesting a 20.3% rate hike.

Large-group market rates:

Blue Cross & Blue Shield of Rhode Island: 19.7% increase approved after requesting a 24.3% rate hike.

UnitedHealthcare Insurance Co.: 17.4% increase approved after requesting a 23.8% rate hike.

Harvard Pilgrim Health Care Insurance Co./Harvard Pilgrim Health Care: 21.7% increase approved after requesting a 26.4% rate hike.

Aetna Inc.: 13.3% increase approved after requesting a 13.5% rate hike.

The Cigna Group: 17.4% increase approved after requesting a 16.8% rate hike.

Individual market rate:

Blue Cross: 22% increase approved after requesting a 28.9% rate hike.
Neighborhood Health Plan: 20.5% increase approved after requesting 23.8% rate hike.

(MINOR edits to tighten.)
Katie Castellani is a PBN staff writer. You may contact her at Castellani@PBN.com.